Guidance on baby swimming

GUIDANCE

What is baby swimming? 

Baby swimming (aka. pre/post-natal swimming, parent and baby) is a programmed swim and hydrotherapy session typically led by a competent instructor. 

The activity is not a hydrotherapy session which is described as "a therapy programme utilizing the properties of water, designed by a suitably qualified physiotherapist specifically for an individual to improve function, carried out by appropriately trained personnel, ideally in a purpose-built, and suitably heated hydrotherapy pool” (HACP, 2006). Definitions aside, the most senior practitioners of aquatic exercise are chartered physiotherapists with an aquatic therapy specialism. Any guidance they produce should be considered best practice for baby swimming instructors. 

What guidance is available? 

The following guidance is available:

• PAS 520:2017. Safeguarding 0 to 4-year-old children within the teaching of swimming, including any associated professional photography. Code of practice. Accessed 6 August 2022. 
• Pelvic Obstetric and Gynecological Physiotherapy. 2017. Aquanatal guidelines. Guidance for antenatal and postnatal exercises in water. Second edition. Accessed 6 August 2022. 
• Swim England. 2017. Submersion of babies. June. Accessed 6 August 2022.
• STA. 2016. Baby swimming policy. 11 April. Accessed 6 August 2022. 
• HSE Ireland. 2018. Healthy and safe swimming with your child. Accessed 6 August 2022.  
• Fitness Australia. 2013. Pre & post-natal exercise guidelines. June. Accessed 6 August 2022. 
• NHS. 2019. Can my baby go swimming before or after vaccinations? Accessed 6 August 2022.  
• Aquatic Therapy Association of Chartered Physiotherapists. 2021. Guidance on aquatic physiotherapy. Accessed 6 August 2022. 
• Aquatic Therapy Association of Chartered Physiotherapists. 2022. Frequently asked questions. Accessed 6 August 2022. 
• PWTAG. 2012. Baby and toddler swimming in warm hydrotherapy pools. Accessed 6 August 2022. 

What are the hazards of baby swimming? 

The following hazards are commonly identified in baby swimming sessions: 

• Submersion in water. 
• Ingestion of small foreign objects by infants or toddlers. 
• Hypothermia from prolonged immersion in cold water. 
• Slipping due to water contamination on a pedestrian walkway. 
• Tripping over objects in a pedestrian walkway. 
• Collision with the pool surround, other pool users, or a foreign object (e.g. floating leisure articles). 
• Health events triggered by exercise. 
• Ingestion or absorption of waterborne pathogens. 
• Air pollution. 

How to conduct baby swimming sessions safely.

Practical steps can be taken to deliver safe baby swimming sessions in swimming pools, including: 

• An adult-to-child ratio of 1:1 should be applied in all sessions (see Admission Policy). There should be a ratio of adults to instructors of 12:1 (see Learner to Teacher Ratios). The operator might require authorization from your health practitioner or a medical professional if your baby was premature before admission. Admission may be restricted if your baby is unwell or has been fed solid food up to an hour before admission. 
• Babies must wear a double nappy (i.e. a paper/reusable nappy with a neoprene nappy over the top). 
• Adults should be advised that applying a barrier cream (i.e. moisturiser) to your baby before the session can help protect your babies skin. 
• Industry guidance is inconsistent on the point of water temperature for babies of a certain weight or age. The ATACP state that swimming pool water temperature must be a maximum of 32 degrees celsius when a baby is under twelve weeks or 5.4kg. Guidance from the STA and PAS 520 provides that pool water should be 32 degrees celsius when the baby is under three months old or weighs less than 5.5kg. The water temperature should not be under 30 degrees celsius during any baby swim session. 
• Use a health commitment statement and/or proportionate screening of health conditions and recommendations from a medical professional to ensure participants are safe for participation in the activity. A list of contraindications which may require additional care to be taken is provided in guidance from the Pelvic Obstetric and Gynecological Physiotherapy Association (2017). 
• Adults should receive a basic induction on their first session to include: whether they can swim, any concerns they have about using the water, and any adjustments the adult needs in place for themselves or their baby as advised by a medical professional (Pelvic Obstetric and Gynecological Physiotherapy Association, 2017). The adult should be advised to update the instructor immediately should any contraindications occur during the session or at the start of any future sessions should they occur before or after a session.  
• Instructors should advise adults that submersion of a baby is permissible under the guidance of a competent professional. A baby should not be submerged in a water depth greater than 1 metre. 
• Instructors should advise adults to avoid swimming using breaststroke to avoid neck extension and the exacerbation of pelvic joint pain. Low squats and side stretches should also be avoided as these can cause additional pelvic pain. 
• Sessions are normally 30 minutes long.  Sessions should be no longer than 60 minutes to reduce the effects of fatigue for adults and children. 
• Screening, requirements, and supervision of third parties to ensure they do not bring unsuitable equipment into the pool. 
• Use of competent instructors to deliver or supervise the delivery of sessions by trainee instructors. Constant poolside supervision is normally provided by the instructor from a position in the water, and guidance has been published on how to do this safely. Additional supervision from the supervising adult and/or any lifeguard on the poolside can also be considered in the risk assessment that determines the required supervision arrangements. 
• Quarantine unsuitable, damaged or unsafe equipment to prevent its use and arrange for repair by a competent person or its disposal. Toys should be sealed to avoid loose parts, and floats should be of a closed foam design. 
• Provide competent first aiders to respond to incidents and provide pre-hospital care should they occur. 

Where the session is conducted in an outdoor swimming pool, the following should also be considered: 

• Do not undertake sessions during lightning storms. 
• Advise participants and instructors to wear sunscreen during warm weather. 
• Advise lifeguards to wear polarizing sunglasses during warm weather.  

Citation. Jacklin, D. 2022. Guidance on baby swimming. Water Incident Research Hub, 29 July.